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What Causes Elevated Anticardiolipin Antibodies?
Question: Hello,
I am 31 years old and I've had 2 miscarriages. My first pregnancy happened the first time we tried, and I miscarried at 11-12 weeks. The second time it took us a whole year to get pregnant again, then I miscarried at 9 weeks, a week after we heard the heartbeat. After running some tests, I learned that I have elevated anticardiolipin antibodies, and blood clotting tendencies (MTHFR). I know I have to take Heparin or Lovenox when I get pregnant. Do you think there is a real need for me to take these medications once I get pregnant? If I do have to take it, should I take it only during the first trimester? Or during the whole pregnancy? I'm hesitant about this protocol because a friend of mine who also had antiphospholipid antibodies, took Haperin while pregnant (for the first trimester) even though she was borderline for her antibody levels, and the doctor later told her she didn't need to take it afterall. She had two strokes after the baby was born and spinal coagulation. Considering all this, are these medications my only options to carry a full term pregnancy? Is there anything else or a different treatment other then Heparin and Lovenox for my particular situation? Or are they my best chances of avoiding miscarriages? I would really like to know if there are any other treatments available for me for when I get pregnant again. I also am hesitant to take crinone 8% (progesterine) as in my last pregnancy, because now that I know I have blood clotting issues, is this relevant? Do you think I should avoid crinone 8% next time I get pregnant?
Can you explain to me exactly what it means to have elevated cardiolipin antibodies? Does this mean the antibodies are attacking the baby or just coagulating the placenta? I know Lovenox have anti inflammatory properties, which will help to not make my immunesystem aggressive, but would you please give me more information on this mechanisms? I want to understand my blood clotting issues in relation to what it seems to be a disfunctional auto immine response to the baby when I get pregnant.
Also, what does it mean to have high protein C functional levels as stated in my tests? Also am I at risk to develop APS or rheumatoid arthritis in the future?
Should I be looking for a hematologist, rheumatologist, reproductive endoctrinologist or reproductive immunologist to help my OBGYN? I feel that I need a specialist involved besides my OBGYN.
I've attached here one test result picture, here is a link for a pdf version of the rest of my test results:
https://www.dropbox.com/s/mfxzmmdpjn3smc0/doc%20final%20jul%2013%2C%202015%2C%2016%3A22.pdf?dl=0
I am 31 years old and I've had 2 miscarriages. My first pregnancy happened the first time we tried, and I miscarried at 11-12 weeks. The second time it took us a whole year to get pregnant again, then I miscarried at 9 weeks, a week after we heard the heartbeat. After running some tests, I learned that I have elevated anticardiolipin antibodies, and blood clotting tendencies (MTHFR). I know I have to take Heparin or Lovenox when I get pregnant. Do you think there is a real need for me to take these medications once I get pregnant? If I do have to take it, should I take it only during the first trimester? Or during the whole pregnancy? I'm hesitant about this protocol because a friend of mine who also had antiphospholipid antibodies, took Haperin while pregnant (for the first trimester) even though she was borderline for her antibody levels, and the doctor later told her she didn't need to take it afterall. She had two strokes after the baby was born and spinal coagulation. Considering all this, are these medications my only options to carry a full term pregnancy? Is there anything else or a different treatment other then Heparin and Lovenox for my particular situation? Or are they my best chances of avoiding miscarriages? I would really like to know if there are any other treatments available for me for when I get pregnant again. I also am hesitant to take crinone 8% (progesterine) as in my last pregnancy, because now that I know I have blood clotting issues, is this relevant? Do you think I should avoid crinone 8% next time I get pregnant?
Can you explain to me exactly what it means to have elevated cardiolipin antibodies? Does this mean the antibodies are attacking the baby or just coagulating the placenta? I know Lovenox have anti inflammatory properties, which will help to not make my immunesystem aggressive, but would you please give me more information on this mechanisms? I want to understand my blood clotting issues in relation to what it seems to be a disfunctional auto immine response to the baby when I get pregnant.
Also, what does it mean to have high protein C functional levels as stated in my tests? Also am I at risk to develop APS or rheumatoid arthritis in the future?
Should I be looking for a hematologist, rheumatologist, reproductive endoctrinologist or reproductive immunologist to help my OBGYN? I feel that I need a specialist involved besides my OBGYN.
I've attached here one test result picture, here is a link for a pdf version of the rest of my test results:
https://www.dropbox.com/s/mfxzmmdpjn3smc0/doc%20final%20jul%2013%2C%202015%2C%2016%3A22.pdf?dl=0
Brief Answer:
You should investigate for anti phospholipid antibody syndrome.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have two miscarriage so there is chance of antiphospholipid antibody syndrome.
But for diagnosis lupus anticoagulant and anti cardiolipin antibody should be positive atleast two times and 12 weeks apart.
Your anti nuclear antibody test is negative so you don't have systematic lupus erythematous related problem.
You have MTHFR gene mutation so it also increase the chance of clotting.
Antiphospholipid antibody syndrom (APS) is an autoimmune, hypercoaguble state caused by antiphospholipid antibodies. It provoke blood clot in artery and vein and causes thrombosis. In pregnancy it cause repeated miscarriage as a result of placental infarct.
Treatment is aspirin and heparin.
Initially low dosage aspirin should be take when pregnancy is detected. After 8 weeks low molecular weight heparin should be taken through out pregnancy.
Don't worry about your crinone. It is helpful in maintaining the pregnancy and it doesn't increase any risk. So you can take it.
Consult your haematologist and start treatment accordingly.
Hope I have answered your question, if you have doubt then I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.
You should investigate for anti phospholipid antibody syndrome.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have two miscarriage so there is chance of antiphospholipid antibody syndrome.
But for diagnosis lupus anticoagulant and anti cardiolipin antibody should be positive atleast two times and 12 weeks apart.
Your anti nuclear antibody test is negative so you don't have systematic lupus erythematous related problem.
You have MTHFR gene mutation so it also increase the chance of clotting.
Antiphospholipid antibody syndrom (APS) is an autoimmune, hypercoaguble state caused by antiphospholipid antibodies. It provoke blood clot in artery and vein and causes thrombosis. In pregnancy it cause repeated miscarriage as a result of placental infarct.
Treatment is aspirin and heparin.
Initially low dosage aspirin should be take when pregnancy is detected. After 8 weeks low molecular weight heparin should be taken through out pregnancy.
Don't worry about your crinone. It is helpful in maintaining the pregnancy and it doesn't increase any risk. So you can take it.
Consult your haematologist and start treatment accordingly.
Hope I have answered your question, if you have doubt then I will be happy to answer.
Thanks for using health care magic.
Wish you a very good health.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you,
I will investigate the APS...
Do you know about treatments like IVIG, or Prednisone and intralipids therapy would those maybe apply to treatment ofmy case?
Do you know if there is anything that can be done do decrease the risks of stroke when I take heparin and baby aspirin?
What does it mean to have elevated Anticardiolipin antibodies? If they are eventually detected positive. Are these antibodies still related to the APS? Or to Lupus?
If I also have endometriosis or PCOS, which blood work is required to establish the diagnosis for both endometriosis ans PCOS?
Do you think I should order more auto-immune exams, such as : "Natural killers", "Th1 and Th2", "T regulatory cells", "Leukocyte antibody detection"? Im afraid I can have more auto-immune problems that were not tested or diagnosed yet.
I just got my miscarriage tests back, and it was an abnormal male. Triploid of maternal origin was detected (presense of an extra set of all chromosomes). Do you know what this would mean in practical terms? was the abnormality of the baby related to my immunological disfunction when I get pregnant?
Thank you, XXXXXXX
I will investigate the APS...
Do you know about treatments like IVIG, or Prednisone and intralipids therapy would those maybe apply to treatment ofmy case?
Do you know if there is anything that can be done do decrease the risks of stroke when I take heparin and baby aspirin?
What does it mean to have elevated Anticardiolipin antibodies? If they are eventually detected positive. Are these antibodies still related to the APS? Or to Lupus?
If I also have endometriosis or PCOS, which blood work is required to establish the diagnosis for both endometriosis ans PCOS?
Do you think I should order more auto-immune exams, such as : "Natural killers", "Th1 and Th2", "T regulatory cells", "Leukocyte antibody detection"? Im afraid I can have more auto-immune problems that were not tested or diagnosed yet.
I just got my miscarriage tests back, and it was an abnormal male. Triploid of maternal origin was detected (presense of an extra set of all chromosomes). Do you know what this would mean in practical terms? was the abnormality of the baby related to my immunological disfunction when I get pregnant?
Thank you, XXXXXXX
Brief Answer:
Heparin is the treatment of choice.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
First of all IV ig or steroids are not helpful and heparin is the treatment of choice.
Warferrin can be given but it is teratogenic and harmful to baby. So heparin should be taken.
Heparin reduce the risk of clotting and prevent the stroke. It is blood thinner and specially used to prevent stroke.
Anticardiolipin antibodies are related to APS. However lupus antibodies are more specific for APS.
Endometriosis and PCOD can be detected by ultrasound abdomen.
No other immunological tests are required at present. If needed we will proceed later on.
Genetic abnormalities in your fetus can be due to APS. APS itself leads to birth defect also.
However genetic counselling and testing is required.
First investigate for APS and start heparin according to your doctor's advice.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
Wish you a very good health.
Heparin is the treatment of choice.
Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
First of all IV ig or steroids are not helpful and heparin is the treatment of choice.
Warferrin can be given but it is teratogenic and harmful to baby. So heparin should be taken.
Heparin reduce the risk of clotting and prevent the stroke. It is blood thinner and specially used to prevent stroke.
Anticardiolipin antibodies are related to APS. However lupus antibodies are more specific for APS.
Endometriosis and PCOD can be detected by ultrasound abdomen.
No other immunological tests are required at present. If needed we will proceed later on.
Genetic abnormalities in your fetus can be due to APS. APS itself leads to birth defect also.
However genetic counselling and testing is required.
First investigate for APS and start heparin according to your doctor's advice.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
Wish you a very good health.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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